title: Transoral open reduction and fixation of mandibular condylar base and neck fractures in children and young teenagers--a beneficial treatment option?
abstract: OBJECTIVE
  To evaluate the possible benefits of open surgery, endoscopically assisted reduction and fixation using a transoral route was used in a selected series of pediatric patients with displaced condylar base and neck fractures.
  
  
  METHODS
  A cohort of 6 patients (1 male and 5 female; age range, 7 to 15 yr; mean, 13.4 yr) with displaced condylar base and neck fractures (n = 9) were included. Inclusion criteria were age younger than 16 years, fracture of the condylar base or neck, and displacement of the fracture by at least 45°. Fractures were classified using conventional radiography, cone-beam computed tomography, or computed tomography. Patients underwent transoral endoscopically assisted open reduction and fixation using miniplate osteosynthesis. Postoperatively, patients were followed clinically and radiographically for 18 months.
  
  
  RESULTS
  Complete follow-up varied from 18 to 35 months (median, 24.5 months). All patients showed normal occlusion and pain-free unrestricted function of the temporomandibular joint at 3, 6, 12, and 18 months postoperatively. There were no signs of incomplete remodeling or deformation of the condyles.
  
  
  CONCLUSIONS
  Transoral endoscopically assisted surgical treatment of severely displaced condylar base and neck fractures in children and young teenagers offers a reliable solution to preclude the sequelae of closed treatment, such as altered morphology and functional disturbances, eliminates visible scars, and lowers the risk of facial nerve damage compared with open reduction using an extraoral approach.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Ludwig Maximilian University, Munich, Germany. sebastian.schiel@med.uni-muenchen.de
authors.forename: Sebastian
authors.initials: S
authors.lastname: Schiel
authors.forename: Peter
authors.initials: P
authors.lastname: Mayer
authors.forename: Florian
authors.initials: F
authors.lastname: Probst
authors.forename: Sven
authors.initials: S
authors.lastname: Otto
authors.forename: Carl-Peter
authors.initials: CP
authors.lastname: Cornelius
mesh_terms: D000293:Adolescent; D001860:Bone Plates; D001863:Bone Screws; D002648:Child; D015331:Cohort Studies; D054893:Cone-Beam Computed Tomography / Q000379:methods; D003766:Dental Occlusion; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D004204:Joint Dislocations / Q000601:surgery; D008297:Male; D008335:Mandibular Condyle / Q000293:injuries* / Q000601:surgery; D008337:Mandibular Fractures / Q000145:classification / Q000601:surgery*; D008904:Miniaturization; D009055:Mouth / Q000601:surgery; D011862:Radiography, Panoramic; D016059:Range of Motion, Articular / Q000502:physiology; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome